A Saudi man who died in the Philippines was suspected to have a MERS-CoV infection, and health officials say he can't be tested due to embalming, but the illness has triggered an intensive search for contacts, including healthcare workers who cared for the man during his hospitalization.
If the case is counted in the Philippines' total for MERS-CoV (Middle East respiratory syndrome coronavirus), the man's illness would be the country's third.
Meanwhile, Saudi Arabia has gone 4 days without a MERS-CoV case. The country had reported a surge of cases, much of it linked to a large hospital outbreak in Riyadh, in the months leading to the Hajj religious observance, which ended last week.
Man embalmed before officials notified
According to media reports, the man died on Sep 29, about 2 weeks after arriving in the Philippines for a vacation, the Philippine Star reported yesterday. Health secretary Janette Garin, MD, said health officials couldn't test the man for MERS-CoV, because he had already been embalmed at a funeral home when the health department learned of the case.
The man reportedly travels to the Philippines twice a year for vacation, and arrived alone from Jeddah on Sep 17 without displaying any MERS symptoms during airport screening. The Star said he stayed in a hotel, where he started having symptoms on Sep 26. On Sep 28 he was hospitalized after reporting a cough, high fever, and breathing difficulties, according to the report.
Garin said the man's condition deteriorated, and he was pronounced dead the next day, according to the report. X-rays were consistent with a MERS-CoV infection, and tests also suggested the man had a heart attack.
So far 101 contacts have been identified, and 15 people—several of them healthcare workers—have been isolated at San Lazaro Hospital and Research Institute for Tropical Medicine.
According to the Star, the health department is coordinating with the World Health Organization to see if the man's illness can be counted as a MERS-CoV cases, given his symptoms and travel history.
Concerned because the private hospital didn't report the man's illness until he had already been brought to the funeral home, Garin said the country's Department of Health will now require a "zero reporting" policy for hospitals to report MERS-CoV cases. She said requiring them to report each week, even if cases are zero, will be a constant reminder to aggressively look for cases.
The earlier Philippines cases include a 31-year-old woman who got sick in late January while working in Saudi Arabia and was diagnosed as having MERS shortly after she returned to Manila. The other patient was a 36-year-old traveler from Finland who tested positive for the virus on Jul 4 after having traveled to Saudi Arabia, with a stop in the United Arab Emirates on his way to the Philippines. Tests a few days later, however, showed that he was clear of the virus.
Saudi Arabia cases stay stable
Based on official daily reports from Saudi Arabia's Ministry of Health (MOH), MERS-CoV activity seems to be slowing down, with no new cases reported over the weekend and through today. Last week the country went 5 days without reporting a new illness.
In the past 4 days, the country reported four more recoveries from the disease, raising the total since the virus first emerged in 2012 to 697. The Saudi illness total remains at 1,251, with the fatality count holding steady at 536.
The MOH said today that 18 patients are still being treated or monitored, which is down from the 50 to 60 patients being managed at the peak of the illness spike in late August.
Camel owners ruffled by warnings
In other Saudi MERS developments, camel owners are threatening legal action against government agencies that say camels are the main source of coronavirus, Riyadh Vision, a newspaper based in the country's capital, reported on Oct 4.
The camel owners said camel prices have dropped, due to what they say is an increase in warnings about and measures involving camels to prevent the spread of MERS-CoV. For example, Saudi officials announced a ban on camel sacrifices during this year's Hajj.
Camels are thought to be one of the main hosts for the virus, but health officials haven't determined definitively what other animals play a role in spreading the virus to humans.
See also:
Oct 4 Philippine Star story
Oct 6 Star story
Oct 5 Saudi MOH statement
Oct 4 Riyadh Vision story
